Provider Demographics
NPI:1225521529
Name:DEHAVEN, SARAH (NP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:DEHAVEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:PATRICIA
Other - Last Name:CLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8700 SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8700 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4418
Practice Address - Country:US
Practice Address - Phone:703-369-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily